A 10-year Retrospective Analysis of the Clinical Characteristics and Outcomes of mature B-Cell Non-Hodgkin Lymphoma in children treated in a tertiary South African Hospital.

Abstract

Background: Mature B-cell Non-Hodgkin lymphoma(B-NHL) is a common childhood malignancy with excellent cure rates in developed countries. There is limited data in Sub-Saharan Africa(SSA) especially with regard to HIV-infected children with B- NHL. Aim: The aim of this study was to compare clinicopathologic characteristics and outcomes in HIV-infected and HIV non-infected children with mature B-NHL. Setting: Chris Hani Baragwanath Academic Hospital, South Africa. Methods: Data were collected for all children diagnosed with mature B-NHL over a 10-year period. This included demographic, clinical, laboratory, radiological, treatment and outcome data. Descriptive statistics, multivariate analysis and a Cox proportional hazard model to determine the hazard ratio were calculated using the statistical programme IBM SPSS version 2. Results: A total of 61 patients were included in this study. The majority of patients were HIV-infected(n=41, 67%). The predominant histological subtype was Burkitt Lymphoma in both groups(40%). The median age of diagnosis in the HIV-infected group was 9.5 years and 5.7 years in the HIV non-infected group (p=0.07). Males were the majority sex in both groups (69%). More HIV-infected patients had a previous history of TB (n=18, p=0.002) and the majority were virally unsuppressed (61%). HIV-infected patients with B-NHL are 19 times more likely to succumb to death compared to HIV non-infected patients with B-NHL (HR=18.8, 95% CI 3.2- 110.3, p=0.001). v Conclusion: This study has shown that HIV-infected patients with B-NHL are 19 times more likely to die compared to their HIV-negative counterparts. Advanced disease at presentation, malnutrition, and treatment toxicity contributed to deaths in the HIV-infected group.